Surgical access device including an anchor having a suture retention mechanism

ABSTRACT

A surgical access device includes a cannula body, an anchor, and a first suture retention mechanism. The cannula body includes a housing and an elongated portion extending distally from the housing. The elongated portion defines a longitudinal axis and a channel extending therethrough. The anchor is disposed in mechanical cooperation with the elongated portion of the cannula body and is longitudinally translatable relative to the elongated portion. The first suture retention mechanism extends laterally from the anchor. A suture-receiving channel is defined between a portion of the suture retention mechanism and a portion of the anchor.

FIELD

The present disclosure relates to a surgical access device. Moreparticularly, the present disclosure relates to a surgical access deviceincluding an anchor with a suture retention mechanism to help maintainits position relative to a patient during a surgical procedure.

BACKGROUND

In minimally invasive surgical procedures, including endoscopic andlaparoscopic surgeries, a surgical access device permits theintroduction of a variety of surgical instruments into a body cavity oropening. A surgical access device (e.g., a cannula) is introducedthrough an opening in tissue (i.e., a naturally occurring orifice or anincision) to provide access to an underlying surgical site in the body.The incision is typically made using an obturator having a blunt orsharp tip that has been inserted within the passageway of the surgicalaccess device. For example, a cannula has a tube of rigid material witha thin wall construction, through which an obturator may be passed. Theobturator is utilized to penetrate a body wall, such as an abdominalwall, or to introduce the surgical access device through the body wall,and is then removed to permit introduction of surgical instrumentationthrough the surgical access device to perform the surgical procedure.

During these procedures, it may be challenging to maintain the positionof the surgical access device with respect to the body wall,particularly when exposed to a pressurized environment. To help maintainthe position of the surgical access device with respect to the bodywall, an anchor positioned near a distal end of the surgical accessdevice and adjacent tissue is occasionally used. Positioning such ananchor while the surgical access device is within the body helpsminimize undesired movement of the surgical access device with respectto the body.

Accordingly, it may be helpful to provide an anchor with a mechanism tohelp maintain the longitudinal position of the surgical access devicewith respect to the patient.

SUMMARY

The present disclosure relates to a surgical access device including acannula body, an anchor, and a first suture retention mechanism. Thecannula body includes a housing and an elongated portion extendingdistally from the housing. The elongated portion defines a longitudinalaxis and a channel extending therethrough. The anchor is disposed inmechanical cooperation with the elongated portion of the cannula bodyand is longitudinally translatable relative to the elongated portion.The first suture retention mechanism extends laterally from the anchor.A suture-receiving channel is defined between a portion of the sutureretention mechanism and a portion of the anchor.

In aspects, the suture-receiving channel may be ring-shaped.

In additional aspects, the first suture retention mechanism may includea cylindrical shoulder in contact with the anchor. The first sutureretention mechanism may include a disc-shaped arm extending laterallyfrom the cylindrical shoulder. The suture- receiving channel may bering-shaped, it may surround the cylinder shoulder, and it may bedisposed between the disc-shaped arm and the anchor.

In aspects, the surgical access device may include a second sutureretention mechanism disposed in mechanical cooperation with the anchor.The second suture retention mechanism may be on an opposite side of theanchor from the first suture retention mechanism.

In additional aspects, the surgical access device may include a sleeveradially surrounding at least a portion of the elongated portion anddisposed distally of the anchor. The sleeve may be made from foam, gel,or rubber.

The present disclosure also relates to a method of performing a surgicalprocedure. The method includes inserting a distal portion of a surgicalaccess device into tissue, positioning a distal end of a sleeve engagedwith an elongated portion of the surgical access device adjacent tissue,positioning a distal end of an anchor adjacent a proximal end of thesleeve, wrapping a suture at least partially around a suture retentionmechanism engaged with the anchor, and inserting the suture throughtissue.

In aspects, the method may include passing the suture through thesleeve. Wrapping the suture at least partially around the sutureretention mechanism may occur prior to inserting the suture throughtissue. The method may also include wrapping the suture at leastpartially around the suture retention mechanism after inserting thesuture through tissue.

In additional aspects, wrapping the suture at least partially around thesuture retention mechanism may include wrapping the suture at leastpartially around a cylindrical portion of the suture retentionmechanism.

In aspects, wrapping the suture at least partially around the sutureretention mechanism may include wrapping the suture 360° around acylindrical portion of the suture retention mechanism.

In additional aspects, the method may include wrapping a second sutureat least partially around a second suture retention mechanism engagedwith the anchor. The method may further include inserting the secondsuture through tissue.

DESCRIPTION OF THE DRAWINGS

Various aspects of the present disclosure are illustrated herein withreference to the accompanying drawings, wherein:

FIG. 1 is a perspective view of a surgical access device including ananchor in accordance with the present disclosure;

FIG. 2 is an assembly view of the surgical access device of FIG. 1;

FIG. 3 is a side view of the anchor of FIGS. 1 and 2;

FIG. 4 is a top view of the anchor of FIGS. 1 and 2;

FIG. 5 is an enlarged view of the area of detail indicated in FIG. 3illustrating a side view of the suture retention mechanism of theanchor;

FIG. 6 is an enlarged view of the area of detail indicated in FIG. 4illustrating a top view of the suture retention mechanism of the anchor;

FIGS. 7-9 are side views of a portion of the surgical access device ofFIGS. 1 and 2 showing various steps of wrapping a suture around a sutureretention mechanism of the anchor; and

FIGS. 10 and 11 are side views of the surgical access device of FIGS. 1and 2 showing portions within tissue, illustrating the anchor in adistal position, and illustrating sutures engaged with the sutureretention mechanism, a portion of the anchor, and tissue.

DETAILED DESCRIPTION

Aspects of the presently disclosed surgical access device will now bedescribed in detail with reference to the drawings wherein like numeralsdesignate identical or corresponding elements in each of the severalviews. As is common in the art, the term “proximal” refers to that partor component closer to the user or operator, i.e. surgeon or physician,while the term “distal” refers to that part or component farther awayfrom the user.

Generally, the surgical access device or cannula, often part of a trocarassembly, may be employed during surgery (e.g., laparoscopic surgery)and may, in various aspects, provide for the sealed access oflaparoscopic surgical instruments into an insufflated body cavity, suchas the abdominal cavity. The cannula is usable with an obturatorinsertable therethrough. The cannula and obturator are separatecomponents but are capable of being selectively connected together. Forexample, the obturator may be inserted into and through the cannulauntil the handle of the obturator engages, e.g., selectively locks into,a proximal housing of the cannula. In this initial position, the trocarassembly is employed to tunnel through an anatomical structure, e.g.,the abdominal wall, either by making a new passage through the structureor by passing through an existing opening through the structure. Oncethe trocar assembly has tunneled through the anatomical structure, theobturator is removed, leaving the cannula in place in the structure,e.g., in the incision created by the trocar assembly. The proximalhousing of the cannula may include seals or valves that prevent theescape of insufflation gases from the body cavity, while also allowingsurgical instruments to be inserted into the body cavity.

Additionally, the surgical access device of the present disclosureincludes an anchor including a suture retention mechanism. The anchor isconfigured to engage tissue to help maintain the cannula in its positionrelative to the body during use. The suture retention mechanism isconfigured to facilitate the securement of a suture to the anchor tohelp maintain the anchor in its position relative to the body duringuse.

FIGS. 1-11 illustrate a surgical access device according to the presentdisclosure. With initial reference to FIG. 1, the surgical access device10 includes a cannula body 100 and an anchor 200. The cannula body 100includes a proximal housing 120 at its proximal end, and includes anelongated portion 140 extending distally from the proximal housing 120.The elongated portion 140 defines a channel 150 (FIG. 2) extendingtherethrough, and defines a longitudinal axis “A-A.” An obturator (notshown) is insertable through the channel 150 and is engageable with theproximal housing 120, for instance.

The anchor 200 is positionable around the elongated portion 140 of thecannula body 100 such that such that the anchor 200 radially surrounds aportion of the elongated portion 140. More particularly, the anchor 200is longitudinally translatable along the elongated portion 140 between afirst position, where the anchor 200 is farther away from a distal tip142 of the elongated portion 140 (FIG. 1), and a second position,wherein the anchor 200 is closer to the distal tip 142 of the elongatedportion 140 (FIGS. 10 and 11). Additionally, the anchor 200 isconfigured to releasably and selectively lock itself into a desiredlongitudinal position.

Referring to FIGS. 1 and 2, the engagement between the anchor 200 andthe cannula body 100 is shown. The anchor 200 includes a clip 220, and ahandle 240. The clip 220 of the anchor 200 defines an aperture 222,through which the elongated portion 140 of the cannula body 100 isinsertable.

FIGS. 3 and 4 illustrate further details of the anchor 200 and thesleeve 260. The clip 220 of the anchor 200 includes an arcuate portion225 having a first end 225 a and a second end 225 b. In aspects, theclip 220 may be C-shaped including an adjustable gap “G” defined betweenthe first end 225 a and the second end 225 b of the arcuate portion 225.The first end 225 a is movable relative to the second end 225 b betweena first orientation defining a first size, larger aperture and a secondorientation defining a second size, smaller aperture. The gap “G”corresponding to the first size aperture is larger than the gap “G”corresponding to the second size aperture. In the first orientation,where the clip 220 defines a larger aperture, the anchor 200 islongitudinally translatable along the elongated portion 140 of thecannula body 100. In the second orientation, where the clip 220 definesa smaller aperture, the anchor 200 is fixed from translatinglongitudinally along the elongated portion 140 of the cannula body 100.

The handle 240 is movable to toggle the orientation of the clip 220.More particularly, and with particular reference to FIG. 4, the handle240 is pivotable about a pivot pin 227 disposed adjacent the first end225 a of the arcuate portion 225. A handle pin 242 of the handle 240 ismovable in the general direction of arrow “B” in FIG. 4 into engagementwith a finger (e.g., a cam finger) 237 disposed adjacent the second end225 b of the arcuate portion 225. The engagement between the handle pin242 and the finger 237 releasably locks the clip 220 into its secondorientation corresponding to the smaller aperture; disengagement of thehandle pin 242 and the finger 237 moves the clip 220 into its firstorientation corresponding to the larger diameter. While a particularaspect is shown for releasably locking and unlocking the clip 220, othermechanisms are usable with the anchor 200 and are within the scope ofthe present disclosure.

Additionally, with reference to FIGS. 3-6, a suture retention mechanism250 is shown engaged with the anchor 200. The suture retention mechanism250 extends outwardly from the clip 220. While two suture retentionmechanisms 250 are shown, the present disclosure contemplates an anchorhaving more or fewer than two suture retention mechanisms 250.Generally, the suture retention mechanisms 250 are usable as locationsto tie sutures to during use, for instance.

With particular reference to FIGS. 5 and 6, the suture retentionmechanism 250 includes a cylindrical shoulder 252 and a disc-shaped arm254. The shoulder 252 extends laterally from the clip 220, and the arm254 extends laterally from the shoulder 252. A ring-like,suture-receiving channel 256 is defined between an outer wall 221 of theclip 220 and an inner wall 255 of the arm 254; the shoulder 252 definesa radially inner boundary of the channel 256 and provides a smoothsurface for engaging the suture “S.”

As shown in FIGS. 7-9, and as discussed in further detail below, duringuse of the surgical access device 10, a suture “S” can be wrapped aroundthe shoulder 252 of the suture retention mechanism 250 such that part ofthe suture “S” is within the channel 256.

A sleeve 260 is shown in FIGS. 1-4, 10, and 11. In aspects, the sleeve260 is secured to the clip 220 such that the sleeve 260 and the clip 220cannot be moved independently of each other. In other aspects, thesleeve 260 and the anchor 200 are movable independently of each other.The sleeve 260 is configured to longitudinally compress in response tobeing moved against a tissue wall “T,” for instance, as indicated byarrow “C” in FIGS. 10 and 11. The sleeve 260 may be made from foam, gel,rubber (e.g., elastomers), or another suitable compressive material.

Additionally, as shown in FIGS. 1, 2, 10, and 11, the anchor 200 can beused in connection with an additional fixation mechanism 300. Forinstance, as shown in FIGS. 10 and 11, while the anchor 200 may bepositioned along the elongated portion 140 of the cannula body 100adjacent a proximal wall of tissue “T” adjacent an incision, thefixation mechanism 300 can radially extend from the elongated portion140 of the cannula body 100 using conventional methods and be positionedadjacent a distal wall of the tissue “T” adjacent the incision, forexample.

Referring now to FIGS. 10 and 11, in use, the anchor 200 is initially ina proximal position along the elongated portion 140 of the cannula body100 as the distal end of the cannula body 100 is being inserted intoand/or positioned within the tissue cavity “TC.” Next, the fixationmechanism 300, if included, is moved to its expanded position, and thecannula body 100 is moved proximally such that the fixation mechanism300 contacts the distal portion of the tissue wall or muscle layer “M,”for instance. Then, the anchor 200 and/or sleeve 260 is/are moveddistally along the elongated portion 140 of the cannula body 100 suchthat the sleeve 260 contacts a proximal portion of the tissue wall orskin “S.” Next, in aspects where the anchor 200 is separate from thesleeve 260, the anchor 200 is moved distally into contact with thesleeve 260. The handle 240 of the clip 220 is then utilized to decreaseand lock the size of the aperture 222 such that the anchor 200 isfixedly positioned on the elongated portion 140 of the cannula body 100.Here, the tissue wall “T” is sandwiched between the sleeve 260 and thefixation mechanism 300, and the longitudinal position of the cannulabody 100 is fixed relative to the tissue wall “T.”

With continued reference to FIGS. 10 and 11, at least one suture “S” isused to further secure the anchor 200 to tissue “T.” More particularly,the suture “S” is wrapped around the suture retention mechanism 250(FIGS. 7-9), passed through (or around) the sleeve 260, passed through alayer of tissue “T,” passed back through (or around) the sleeve 260, andwrapped around the suture retention mechanism 250 again. This additionalsecurement using the suture “S” not only helps secure the position ofthe anchor 200 with respect to the tissue “T,” but also helps keep thesleeve 260 in contact with the tissue “T” which may help to absorbbodily fluids, such as blood, that may exit the incision. In the aspectillustrated in FIGS. 10 and 11, a first suture “S1” is wrapped aroundone suture retention mechanism 250, and a second suture “S2” is wrappedaround another suture retention mechanism 250.

In the aspect of FIG. 10, the sutures “S1” and “S2” are secured to anouter layer of tissue, e.g., the skin “SK.” Here, after completion ofthe surgical procedure, the surgical access device 10 is removed fromthe incision, and the sutures “S1” and “S2” are also removed anddiscarded.

In the aspect of FIG. 11, the sutures “S1” and “S2” are secured to aninner layer of tissue, e.g., the muscle layer “M.” Here, aftercompletion of the surgical procedure, the sutures “S1” and “S2” areunwrapped from the suture retention mechanisms 250, the surgical accessdevice 10 is removed from the incision, and the sutures “S1” and “S2”remain secured to the inner layer of tissue and are further used to helpclose the incision.

While the above description contains many specifics, these specificsshould not be construed as limitations on the scope of the presentdisclosure, but merely as illustrations of various aspects thereof.Therefore, the above description should not be construed as limiting,but merely as exemplifications of various aspects. Those skilled in theart will envision other modifications within the scope and spirit of theclaims appended hereto.

What is claimed is:
 1. A surgical access device, comprising: a cannulabody including a housing and an elongated portion extending distallyfrom the housing, the elongated portion defining a longitudinal axis anda channel extending therethrough; an anchor disposed in mechanicalcooperation with the elongated portion of the cannula body and beinglongitudinally translatable relative to the elongated portion; and afirst suture retention mechanism extending laterally from the anchor,wherein a suture-receiving channel is defined between a portion of thesuture retention mechanism and a portion of the anchor.
 2. The surgicalaccess device according to claim 1, wherein the suture-receiving channelis ring-shaped.
 3. The surgical access device according to claim 1,wherein the first suture retention mechanism includes a cylindricalshoulder in contact with the anchor.
 4. The surgical access deviceaccording to claim 3, wherein the first suture retention mechanismincludes a disc-shaped arm extending laterally from the cylindricalshoulder.
 5. The surgical access device according to claim 4, whereinthe suture-receiving channel is ring-shaped, the suture-receivingchannel surrounds the cylinder shoulder, and the suture-receivingchannel is disposed between the disc-shaped arm and the anchor.
 6. Thesurgical access device according to claim 3, wherein thesuture-receiving channel surrounds the cylindrical shoulder.
 7. Thesurgical access device according to claim 1, wherein the surgical accessdevice includes a second suture retention mechanism disposed inmechanical cooperation with the anchor.
 8. The surgical access deviceaccording to claim 7, wherein the second suture retention mechanism ison an opposite side of the anchor from the first suture retentionmechanism.
 9. The surgical access device according to claim 1, furtherincluding a sleeve radially surrounding at least a portion of theelongated portion and disposed distally of the anchor.
 10. The surgicalaccess device according to claim 9, wherein the sleeve is made fromfoam, gel, or rubber.
 11. A method of performing a surgical procedure,comprising: inserting a distal portion of a surgical access device intotissue; positioning a distal end of a sleeve engaged with an elongatedportion of the surgical access device adjacent tissue; positioning adistal end of an anchor adjacent a proximal end of the sleeve; wrappinga suture at least partially around a suture retention mechanism engagedwith the anchor; and inserting the suture through tissue.
 12. The methodaccording to claim 11, further including passing the suture through thesleeve.
 13. The method according to claim 12, wherein wrapping thesuture at least partially around the suture retention mechanism occursprior to inserting the suture through tissue, and further includingwrapping the suture at least partially around the suture retentionmechanism after inserting the suture through tissue.
 14. The methodaccording to claim 11, wherein wrapping the suture at least partiallyaround the suture retention mechanism includes wrapping the suture atleast partially around a cylindrical portion of the suture retentionmechanism.
 15. The method according to claim 11, wherein wrapping thesuture at least partially around the suture retention mechanism includeswrapping the suture 360° around a cylindrical portion of the sutureretention mechanism.
 16. The method according to claim 11, furtherincluding wrapping a second suture at least partially around a secondsuture retention mechanism engaged with the anchor.
 17. The methodaccording to claim 16, further including inserting the second suturethrough tissue.